Why Some Men Can’t Pee in Front of Other People

Is he looking at me? Why is he looking at me? Why is he grunting like that? Does he have to hover so close? I’ll just wait until he leaves. Uh-oh, someone else just walked in…

That’s my best guess at the inner monologue of a man standing at a stall, penis in hand, waiting for his flow to commence, knowing with painful certainty that it’s never going to happen with all these other people around.

But what is it that separates those of us who are free to pee wherever, whenever, and the folks standing by our sides, eyes closed, desperately trying to coax out a single drop?

“Men with enlarged prostates can take a while to start (i.e., hesitancy) or take forever to finish (i.e., weak stream),” explains Jamin Brahmbhatt, a board-certified urologist. “Or the guy may have a clinical disorder called shy bladder syndrome (aka paruresis) which is a form of social phobia.”

The latter might sound made up, but it’s a real thing with real symptoms, according to Brahmbatt. “The symptoms range from difficulty starting to pee in front of others — but they can still eventually do it — to the other extreme, where they can’t pee at all unless they’re alone at home.”

So how is a guy to tell whether he’s a victim of paruresis, or if he’s toting around an enlarged prostate? “Men are usually diagnosed with paruresis after all anatomic conditions (like enlarged prostate, neurogenic bladder) are ruled out,” says Brahmbatt. “Treatments can include behaviour therapy and medications that are similar to those that treat anxiety.”

There’s also a third, less talked-about grouping of men who are unable to pee in front of other people. “Some men may just be conscious of their privates being exposed and seen by other guys,” says Brahmbatt.